In mental healthcare, discoverability might be a bigger problem than capacity

About one in four adults in the United States reports an unmet need for mental healthcare. And even when they find it, wait times can range from weeks to months, leaving many individuals to navigate times or stress or crisis on their own. 

The most common explanations are workforce shortages, and a demand that far exceeds capacity.  After all, with 137 million Americans living in a designated mental health shortage area, it makes sense to pin the problem primarily on the fact that qualified clinicians simply don’t exist in the numbers they need to.  

But new data from Simple Practice indicates that there may be some overlooked nuances to the situation.  It’s not just that there aren’t enough providers.  It’s that even when there are providers available, patients aren’t finding them consistently enough to take advantage of their open appointments, leaving appointments unfilled and needs unaddressed. 

The annual survey of counselors, social workers, therapists, psychologists, and psychiatrists using the company’s practice management tools found that around 60% of independent mental health practitioners have availability within the next seven days.  An average of eighty percent remain open to new clients in general.    

Most surprisingly, practitioners in some of the most rural states show above-average appointment availability.  In areas such as Utah, Iowa, North and South Dakota, and Kansas, more than 70% of clinicians in each state reported availability within 7 days. 

That puts a challenging new twist on the accepted narrative of too many patients and not enough providers. So, if the numbers aren’t adding up, what else is contributing to the problem – and how can the mental healthcare system solve for it? 

The discoverability dilemma facing independent practitioners

“We are seeing that prospective patients aren’t finding their way to the clinicians who are actually available and willing and interested in seeing more clients,” said Lindsay Oberleitner, PhD, LP, lead author on the report and the Head of Clinical Strategy at SimplePractice.  

“These are often small groups or solo practitioners who are having trouble competing with getting their names to be shown in the search engines or the directories, because they don’t have the technical and business savvy to make that happen.” 

In fact, 43% of survey respondents said they have had no training at all in running a business, including using technology to market their practice and get themselves connected to local referral networks.    

“It’s not something you learn in your graduate training, even though most mental health practitioners will go into solo practice at some point in their careers.”  

Right now, much of the work of getting discovered is completed one handshake at a time, added Ish Bhalla, MD, MS, a practicing psychiatrist and a member of Simple Practice’s independent Clinical Advisory Board.  

“You don’t just open a practice and have your books filled on day one,” he said.  “You have to get out there into the community and have lunch with the primary care providers, meet people, build a good website, and market yourself to the best of your ability.  Unfortunately, without the right resources and support, that can be a slow and very individualized process.” 

“As independent practitioners who value self-direction and everything that comes along with being our own bosses, we’re willing to put in that work,” he stressed.  “But we need better tools and stronger connections across the healthcare system to support us and equip us with what we need to succeed, because independent practitioners are the engine of the mental healthcare system.” 

Creating stronger pipelines for matching patients with providers

Maximizing unused capacity will require a combination of digital strategies and enhanced training opportunities for business owners, Oberleitner and Bhalla both agreed. 

The first step is to improve existing technologies, such as provider directories and web searches, to make independent clinicians easier to find.  

“No one is searching for ‘an available LPC in this zip code who accepts this insurance and treats this condition,” Oberleitner said.  “They’re searching for ‘therapist near me,’ and they’re probably not doing it on a specialized mental health directory or health plan portal.  Likewise, a lot of mental health providers who focus on high-needs areas, like depression, anxiety, or LGBTQIA+ issues, aren’t putting that information into the places it needs to be to get seen by the search or referral tools.” 

Payers, larger provider networks, and even Big Tech search engines and AI chatbots will need to work with independent clinicians to improve provider directories, search and filtering tools, and referral platforms to build the technical scaffolding for improved discoverability. 

However, that will mean that independent clinicians with capacity will need better training on how to engage in this new ecosystem. 

In this environment, business literacy is a core patient access issue.  Marketing, referral development, website management, insurance navigation, and directory optimization aren’t just operational tasks – they’re critical skills for expanding access when other methods of connecting patients with care have already been tapped out. 

Graduate programs and professional societies should consider offering more support in these areas, including training on how to best leverage emerging AI capabilities.   

The survey showed that only 47% of practitioners use AI in any capacity, mostly for note taking, treatment planning, and writing emails.  A small number mentioned employing AI tools for marketing, but there is significant room for growth in this area. 

“Every hour spent figuring out SEO, website building, or doing analog outreach to clinical partners is an hour I’m not spending with patients,” Bhalla said.  “When AI plays a larger role in automating some of those things and taking the burden off the practitioner, it helps the entire system run more smoothly and optimize our capacity even further.”  

Ultimately, the survey shows that mental health access issues are about much more than how many providers exist in a given geographical region.  It’s also about how effectively the system connects patients with the resources they need.  As the demand for mental healthcare services continues to rise, investing in new strategies to unlock existing capacity may be the one of the fastest and most effective ways to relieve the pressure on the pipeline without solely relying on expanding the workforce with new practitioners. 

Jennifer Bresnick is a journalist and freelance content creator with a decade of experience in the health IT industry.  Her work has focused on leveraging innovative technology tools to create value, improve health equity, and achieve the promises of the learning health system.  She can be reached at [email protected].